RecruitingPhase 1Phase 2NCT05197270

4D-150 in Patients With Neovascular (Wet) Age-Related Macular Degeneration

A Phase 1/2 Dose-Escalation and Randomized, Controlled, Masked Expansion Trial of Intravitreal 4D-150 Gene Therapy in Adults With Neovascular (Wet) Age-Related Macular Degeneration


Sponsor

4D Molecular Therapeutics

Enrollment

215 participants

Start Date

Dec 9, 2021

Study Type

INTERVENTIONAL

Summary

Phase 1/2 dose-escalation and randomized, controlled, masked expansion trial in adults with wet AMD undergoing active anti-VEGF treatment. Substudies will evaluate the safety and tolerability of 4D-150 contralateral eye dosing and characterize vector shedding.


Eligibility

Min Age: 50 Years

Inclusion Criteria31

  • years of age
  • ≥50 years of age
  • Diagnosed with CNV secondary to AMD (confirmed by reading center)
  • BCVA ≥34 ETDRS letters (~20/200) in the contralateral eye, and BCVA in the study eye:
  • Central subfield thickness (CST) and/or presence of subretinal or intraretinal fluid requiring continued anti-VEGF therapy in the study eye, as assessed by SD-OCT; and confirmed by a reading center):
  • Study eye amenable to IVT injection
  • Ability to perform tests of visual and retinal function and structure, and ability to comply with other protocol-specified procedures
  • Currently receiving anti-VEGF treatment (e.g. ranibizumab, aflibercept, faricimab or bevacizumab) in the study eye AND has demonstrated a clinical response consistent with anti-VEGF activity within 12 months prior to screening:
  • Note: Day -7 aflibercept will be administered ≥ 4 weeks from last IVT anti-VEGF
  • Subjects receiving 4D-150 agree to use a barrier method (e.g. condom) during intercourse for 6 months after administration of 4D-150 to prevent fluid transmission; sexually active males should not father a child or donate sperm during this period
  • Medical records available to document history of anti-VEGF therapy (dates, drugs, and dosage) for a minimum of 12 months prior to Screening
  • Provide written informed consent.
  • Contralateral Eye Sub-study-Specific Criteria:
  • Received 4D-150 in study eye-1 at least 6 months prior to Contralateral Substudy Screening Visit NOTE: Subjects who received 4D-150 in study eye-1 as part of the Shedding Substudy are also eligible to participate in the Contralateral Eye Substudy only after biological samples from all matrices were at or below the limit of quantitation for vector genomes in at least 3 consecutive measurements AND at least 6 months has passed since 4D-150 administration to study eye-1.
  • Macular neovascularization (MNV) secondary to AMD in study eye-2 as assessed on historical images at any time by SD-OCT (required) and FA when available or fundus photography when available or at screening based on SD-OCT, FA and fundus photography (confirmed by the reading center)
  • History of at least 1 anti-VEGF injection in study eye-2 within 6 months prior to Screening (last anti-VEGF injection must be at least 28 days prior to Screening) AND has demonstrated a clinical response consistent with anti-VEGF activity by historical OCT at any time point prior to screening with confirmed response by the reading center (Screening OCT can be confirmatory)
  • BCVA between 25 and 83 ETDRS letters, inclusive (20/320 20/25 Snellen) in study eye-2
  • Study eye-2 amenable to IVT injection
  • BCVA ≥34 ETDRS letters (~20/200) in the previously treated study eye-1
  • Ability to comply with protocol-specified procedures and visits, in the Investigator's judgment
  • Agree to use a barrier method (e.g. condom) during intercourse for 6 months after administration of 4D-150 to study eye-2 to prevent fluid transmission; sexually active males should not father a child or donate sperm during this period
  • Provide written informed consent.
  • ≥50 years of age
  • Diagnosed with MNV secondary to AMD as assessed on historical images at any time by spectral domain optical coherence tomography (SD-OCT) (required) and fluorescein angiography when available or fundus photography when available or at screening based on SD-OCT, FA and fundus photography (confirmed by Reading Center)
  • Best corrected visual acuity (BCVA) between 10 and 83 ETDRS letters, inclusive (~20/640 and 20/25, respectively) in the study eye at Screening
  • BCVA ≥34 ETDRS letters (~20/200) in the contralateral eye
  • Currently receiving anti-VEGF treatment (e.g. ranibizumab, aflibercept, faricimab or bevacizumab) in the study eye; minimum of 1 injection within the last 6 months (last anti-VEGF injection must be at least 28 days prior to screening) AND has demonstrated a clinical response consistent with anti-VEGF activity by historical OCT at any time prior to screening with confirmed response by the reading center (Screening OCT can be confirmatory)
  • Study eye amenable to IVT injection
  • Ability to perform tests of visual and retinal function and structure, and ability to comply with other protocol-specified procedures, in the Investigator's judgment
  • Agree to use a barrier method (e.g. condom) during intercourse for 6 months after administration of 4D-150 to prevent fluid transmission; sexually active males should not father a child or donate sperm during this period
  • Provide written informed consent.

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Interventions

BIOLOGICAL4D-150 IVT

4D-150: AAV-based gene therapy comprised of miRNA targeting VEGF-C and codon-optimized sequence encoding aflibercept

BIOLOGICALAflibercept IVT

Commercially available Active Comparator Other Name: Eylea


Locations(25)

Barnet Delaney Perkins Eye Center

Phoenix, Arizona, United States

California Retina Consultants

Oxnard, California, United States

Retinal Consultants Medical Group

Sacramento, California, United States

Colorado Retina Associates

Lakewood, Colorado, United States

Rand Eye Institute

Deerfield Beach, Florida, United States

Retina Vitreous Consultants, LLP DBA Retina Group of Florida

Fort Lauderdale, Florida, United States

Vitreo Retinal Associates

Gainesville, Florida, United States

Florida Eye Associates

Melbourne, Florida, United States

Retinal Specialty Institute

Pensacola, Florida, United States

Retina Vitreous Associates of Florida

Tampa, Florida, United States

University Retina and Macula Associates

Oak Forest, Illinois, United States

Retina Partners Midwest

Carmel, Indiana, United States

Cumberland Valley Retina Consultants

Hagerstown, Maryland, United States

Ophthalmic Consultants of Boston & Boston Eye Surgery and Laser Center

Boston, Massachusetts, United States

Sierra Eye Associates

Reno, Nevada, United States

Western Carolina Retinal Associates

Asheville, North Carolina, United States

Verum Research, LLC

Eugene, Oregon, United States

Mid Atlantic Retina

Bethlehem, Pennsylvania, United States

Palmetto Retina Center, LLC

West Columbia, South Carolina, United States

Tennessee Retina

Nashville, Tennessee, United States

Austin Clinical Research

Austin, Texas, United States

Valley Retina Institute, PA

McAllen, Texas, United States

Retina Consultants of Texas

The Woodlands, Texas, United States

Pacific Northwest Retina LLC

Bellevue, Washington, United States

Emanuelli Research and Development Center, LLC

Arecibo, Puerto Rico, Puerto Rico

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NCT05197270